CASE

“If you weren't so fat”

After undergoing a Cesarean section, a very fat woman developed a wound infection that was not healing. The chief resident, who had also performed the surgery, became very frustrated over the fact that this untoward event had occurred on his watch. He rebuked the patient in front of a room full of students and house staff by telling her, “If you weren't so fat this simply wouldn't be a problem.”

The patient happened to be Tongan and, consequently, she did not understand most of what the chief resident was saying. He continued to rail away at her in front of the assembled group, punctuated by an occasional, “You understand what I'm talking about don't you!” The patient would simply smile and nod, clearly uncomprehending.

I believed the patient was being used for the chief resident to absolve himself of any responsibility for the infection. As on-lookers, and underlings, what should we have done?

CASE

“The patient removed the traction”

When my friend and I were students on the ward, he was assigned the responsibility of arranging for traction to be set up for a patient. From subsequent events, I believe that he mistakenly ordered the wrong traction and then blamed the patient.